[ rapid situation assessment [RSA] study of alcohol and drug use in Lebanon]

Research on substance use and misuse in Lebanon is scarce and, when available, focuses on a specific substance or a limited segment of the population. The objective of this Rapid Situation Assessment [RAS] study was to survey the use of multiple substances in diverse segments of the Lebanese population. A multi-method and multi-sample survey was conducted to collect quantitative and qualitative data from the academic sector [high school and university students], substance users in treatment or under arrest [prison, detention], and non-institutionalized "street" users. Age of first use of substances started as early as 9 years in the youth sample. Moreover, 12% of the high school students reported smoking one or more packs of cigarettes per day and 9% of the university students met criteria for DSM-IV alcohol abuse. Cannabis represented the most commonly used illicit drug in both high school and university students, and tranquilizers were the most frequently misused medicinal substance. Heroin was responsible for 50% of the treatment admissions, followed by cocaine [20%], and alcohol [20%]; heroin was also the most common substance of arrest. Recidivism was almost the rule for heroin users across all treatment settings. Unperceived need for treatment was the most common reason for not seeking treatment in non-institutionalized drug users [47.6%]. Injecting drug use was a common behavior noted within substance using populations, in treatment and non-institutionalized [about 50% of them], with a high rate of needle sharing practices. About half of all patients in treatment had a history of police arrests, and about one-third of those in prison ever received prior treatment for substance use. The study points towards a growing trend for substance use problems in early adolescence that warrants close monitoring. Further investigation of these patterns is needed since the Lebanese population might have specific pathways of abuse. There is a need to bring together various health, legislative, and academic stakeholders for a continuous appraisal of data from substance abuse studies as evidenced by the recent, although slow, progress in the fields of legislation and treatment that follow such concerted efforts

Lifetime prevalence of mental disorders in Lebanon: first onset, treatment, and exposure to war

There are no published data on national lifetime prevalence and treatment of mental disorders in the Arab region. Furthermore, the effect of war on first onset of disorders has not been addressed previously on a national level, especially in the Arab region. Thus, the current study aims at investigating the lifetime prevalence, treatment, age of onset and its relationship to war in Lebanon. The Lebanese Evaluation of the Burden of Ailments and Needs of the Nation study was carried out on a nationally representative sample of the Lebanese population [n = 2.857 adults]. Respondents were interviewed using the fully structured WHO Composite International Diagnostic Interview 3.0. Lifetime prevalence of any Diagnostic and Statistical Manual of Mental Disorders, fourth edition [DSM-IV] disorder was 25.8%. Anxiety [16.7%] and mood [12.6%] were more common than impulse control [4.4%] and substance [2.2%] disorders. Only a minority of people with any mental disorder ever received professional treatment, with substantial delays [6 to 28 y] between the onset of disorders and onset of treatment. War exposure increased the risk of first onset of anxiety [odds ratio [OR]: 5.92, 95% confidence interval [CI]: 2.5-14.1], mood [OR 3.32, 95% CI 2.0-5.6], and impulse control disorders [OR 12.72, 95% CI 4.5-35.7]. About one-fourth of the sample [25.8%] met criteria for at least one of the DSM-IV disorders at some point in their lives. There is a substantial unmet need for early identification and treatment. Exposure to war events increases the odds of first onset of mental disorders

Suicidality in the Arab World part II: Community studies

This paper reviews hospital and government based articles on suicidality in the Arab world. A systematic search was conducted up to 2006 [Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Morocco, Oman, Palestine, Saudi Arabia, Sudan and United Arab Emirates]. Results varied across countries and methods. The Arab hospital studies, estimated annual rates of attempted suicide ranging from 1.9/100, 000 to 127/100, 000. The Arab police and government records reported annual completed suicide rates of 1.1/100, 000 to 6.2/100, 000. Several risk factors were identified. While in hospital based studies, attempt was related to being single, aged 15-25 years, primary to secondary level education, students, housewives, unemployed, belonging to over-crowded large families, and having a low socio-economic status. In addition, many psychiatric disorders were identified as risk factors, most commonly depressive disorders, adjustment, personality, and drug dependence/abuse disorders. Completed suicide victims were more frequently males, 20 to 40 years old, single, manual workers and unemployed. In conclusion, accurate recording methodology in hospitals and governmental institutions are needed to assess the prevalence and risk factors of suicidal behaviours in the Arab World

Epidemiologic assessment of substance use in the Arab world

Epidemiological studies on substance use are rare in the Arab world. The purpose of this paper is to present a systematic review of all published epidemiologic research in the Arab world up to 2007 using several search engines such as PubMed, PsycInfo, and IDRAAC web database. Research in the Arab world was conducted on specific subpopulations ranging from students to autopsies, at times on large numbers and only one published article on a national basis. Despite the rigid laws against substance use in this region, alcohol is the most used substance, especially among high school and university students ranging from 4.3% to 70.1%. Males use substances more than females except for tranquilizers and barbiturates, the trends changing in a recent report from the L.E.B.A.N.O.N study. As reported by Western counterparts, substances carry a burden on several levels including social impairment, problems of violence, and HIV. Risk factors for substance use include mainly family problems and peer pressure. However, there remains a clear need for national data on substance use in the Arab world in an attempt to identify the magnitude of the problem, and track it for proper monitoring and intervention

Suicidality in the Arab World part I: community studies

This paper reviews published community based studies that assessed suicidality in the Arab world. A search was conducted on several search engines [PubMed, Psychinfo, IDRAAC WEB/CD] up to 2006 [Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Morocco, Oman, Palestine, Saudi Arabia, Sudan and United Arab Emirates]. Results varied across countries and methods. In Arab community studies, the prevalence of lifetime suicide ideation varied from a low of 2.09% to a high of 13.9% and the lifetime prevalence of attempts from 0.72% to 6.3%. In about all community studies which assessed lifetime and 12 months suicide, ideation was significantly related to being a female. Twelve month suicide ideation was significantly related to depressive symptoms and experiencing more life events, illnesses and using more tranquilizers/sleeping pills. One month's suicide ideation was related to non-married status, not having children and a history of psychiatric disorders, specifically MDD, dysthymia, agoraphobia, OCD and GAD. When compared to female university students, females who were displaced or refugees were significantly more likely to report suicide ideation [within the "past few weeks"]. In conclusion, national epidemiological studies are needed to assess the prevalence and risk factors of suicidal behaviors in the Arab World

Depression et grossesse

One hundred fifty females admit consecutively during the months of May and April 1987 during the "Lebanon Wars" to the delivery suite at Saint-Georges Hospital, Beirut, were interviewed using a structured questionnaire [DLS]. The study was one of the pilot studies of our later initiated studies on depression in Lebanon. The study was conducted in two phases: the first on the second post-delivery day [1987] the second one year later.The prevalence of major depression in these 1 females was found to be: 31.3% lifetime, 10% during pregnancy and 10.9% during one year follow-up.Lifetime depression increased with the number children in the household.Depression during pregnancy was found to be in versely related to economic and educational levels

Issues in psychiatric research and diagnosis

Diagnosis in psychiatry, as in other fields of medicine is a very important step in the development of research. This article reviews its importance and its progress in the field of psychiatry. Important yardstics are: Feighner Criteria, Research Diagnotic Criteria, DSMIII-R and IDC-X

Demonic possession and multiple personality disorder

Demonic Possession has accompanied the history of man and still does. Multiple personality disorder [MPD] could be the diagnosis of most of these cases